Experts outline how pandemic has ushered in a children's hunger and housing crisis

With record-breaking unemployment, millions falling behind in rent and mile-long food bank lines, the COVID-19 pandemic has also led to a food and housing crisis of epic proportions.

When covering the soaring food and housing insecurity plight facing the country, it’s important for reporters to set anecdotal stories amid a broader societal framework, said Dr. Megan Sandel, an associate professor of pediatrics at the Boston University School of Medicine.

While the hook offered by the personal story is important, she encouraged reporters to go deeper and describe the policy and structural inequities that underlie these struggles.

“It’s not by accident that low-income kids of color, particularly black and Hispanic kids and Latinx kids have the highest rates of food insecurity,” she said in a Center for Health Journalism “Covering Coronavirus” webinar this week.

Sandel, the co-director of The Grow Clinic at Boston Medical Center, joined Megan V. Smith, an associate professor of psychiatry in the Yale School of Medicine, to discuss the crisis of child hunger and homelessness in the United States, a plight significantly worsened by the ongoing pandemic. They described the impact of food insecurity on young children’s brains, the mental toll of scarcity on caregivers, promising interventions that offer hope, and ideas and advice for reporters on how to best approach the story.  

Major impact on developing brains

Within the first 1,000 days of a child’s life, there is a major cognitive burst as the growing brain forms connections and prunes networks, Sandel said. During this critical period, millions of American children are at risk from the country’s rising food insecurities, something that can adversely affect their brain development during that critical window.  

“As we think of who is the most vulnerable in our society, it really is young children,” she said, adding that “these children predominately live in low-income families.”

Sandel referred to Maslow’s “hierarchy of needs”: If you don’t have basic needs like food and water or safety available, children will face developmental obstacles limiting their potential.

Compared to those with stable housing, families that are falling behind on rent or moving multiple times face long-lasting health obstacles, such as higher rates of maternal depression and food insecurity.

“As we think about the impending doom of people falling behind in rent during this pandemic…even being behind on rent has that stress that’s going to be associated with adverse health,” she said.

Pandemic adds to inequities

The pandemic is adding to existing inequities, leading to a “deep cascade effect,” Sandel said. Poorer neighborhoods are facing higher numbers of COVID-19 cases, likely driven by higher numbers of essential workers, families who move frequently and overcrowding. (Reporters can check out this research site for data on how neighborhoods matter.)

Similarly, at The Grow Clinic, where Sandel works with children experiencing “failure to thrive,” about 20% to 30% of families previously reported not having available food consistently throughout the month. Now that number is closer to 60%.  

That means there are plenty of stories to pursue. She suggested journalists explore what happens when eviction moratoriums expire, and what steps cities are taking for rent assistance (Check out the database from the Eviction Lab at Princeton University).

Mental load of poverty

There’s strong evidence that shows economic shock can worsen mental health, Smith, the Yale psychiatry professor, said. Those increases in depression and anxiety lead to profound impacts on the children they care for.

“When a parent’s mental health really decreases, we know that this negatively impacts and really has pernicious long-lasting impact on child wellbeing,” she said.

The mental load of poverty can take up so much space in the brain that there’s not enough room to think about other activities, such as singing to a child, reading to a child and interacting with a child, all of which have been shown to be crucial for healthy brain development.

“It’s not by accident that low-income kids of color, particularly black and Hispanic kids and Latinx kids have the highest rates of food insecurity.” — Dr. Megan Sandel, Boston University School of Medicine 

The political scientist Robert Putnam called this “Goodnight Moon time,” or that scheduled time at night in which parents read to their children and bond — time that diminishes as a family’s income decreases. 

Scarcity doesn’t just come from a lack of food; it can also be evident in a family’s inability to pay for diapers, something that no federal programs currently support.  

During the pandemic, more and more families are choosing to forgo diapers in order to keep food on the table. For example, one Washington, D.C. diaper bank saw a 300%  increase in demand this year.

That inability to supply enough diapers to keep your child clean and dry adds to a mother’s emotional burden.

“If you’re worried about supplying diapers for your child, that really doesn’t leave a lot of room for attachment and bonding and doesn’t allow for a feeling of self-efficacy and confidence often in parenting,” she said.

There is a glimmer of hope: Effective interventions to treat depression and anxiety in mothers can benefit children, too. And, supportive adults who care can also serve as buffers for children in times of scarcity, fear and trauma.

Smith suggested reporters explore ways that mental health for mothers and poverty alleviation programs can be integrated, such as providing cognitive behavioral group therapy in community hubs like supermarkets, public libraries and homeless shelters. Another important program – especially during COVID-19 — uses community mental health ambassadors.

Reporters can also look into strategies that bundle support for mothers. That could mean diaper assistance, housing assistance, automatic enrollment in programs like the Women, Infants and Children (WIC) nutrition program, or programs such as “baby bonds,” all of which can address parts of the racial wealth gap.

In covering diaper shortages, explore the connection with parental stress, and the negative impact on child growth and development. Look for innovative strategies such as mobile vans or “diaper drive-thrus.” Keep in mind the broader impact of the pandemic: Along with increased needs, there are also fewer volunteers due as well as distribution and supply shortages. (To report on the diaper shortage, check out the National Diaper Bank Network.)

Smith suggested including  potential policy solutions in these stories. For instance, a bipartisan group of senators has recently called for $200 million in diaper assistance.

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Watch the full presentation here: